Tuesday, March 18, 2008

Cognitive Therapy (Part 1)

Years ago I heard about cognitive therapy and bought a book entitled Cognitive Therapy: Basics and Beyond by Judith S. Beck, Ph.D. (Her father, Aaron Beck, M.D., developed the cognitive model.) At the time, the book presented two problems for me. The first was that it's geared toward therapists, and perhaps I felt it was too judgmental toward patients. The second was that the very definition of this type of therapy bothered me.

"In a nutshell, the cognitive model proposes that distorted or dysfunctional thinking (which influences the patient's mood and behavior) is common to all psychological disturbances. Realistic evaluation and modification of thinking produce an improvement in mood and behavior. Enduring improvement results from modification of the patient's underlying dysfunctional beliefs."

The reason this bothered me was because I was so tired of reading that everyone who's bipolar or depressed is dysfunctional and has low-esteem that I could have screamed. It felt like everywhere I looked, the doctors writing books were blaming us for our illness. (Before my diagnosis and subsequent medication merry-go-round, my self-esteem was just fine.)

If I could have gotten beyond the original definition of cognitive therapy, I might have understood that the key to cognitive therapy is that "people's emotions and behaviors are influenced by their perception of events. It is not a situation in and of itself that determines what people feel but rather the way they construe a situation."

And I agree with that. Thus, the same situation that may cause me to feel angry may not affect you at all and vice versa.

What I now believe is that this type of therapy might have been helpful. Recently, I've realized that my behavior and perceptions have changed as a result of this illness. After all these years of seeking help and finding most of the therapists and psychiatrists (I've seen) to be clueless about this illness, I can now see that with certain people in certain situations, I have become angry and unforgiving--which I never was before.

While I still dislike the word, dysfunctional, I could agree that my emotional response to situations and people isn't what it used to be. My "core beliefs," which used to be life-affirming and positive, have changed. (more to come)

If you have experience with cognitive therapy, please let us know how you feel about it.


ariadneK, Ph.D. said...

I don't have experience with cognitive therapy, but that's partially because i don't WANT to: judgmental hogwash is what I largely consider it to be. If it helps "some" people then great, but otherwise, it is not for me.

Bipolar Wellness Writer said...

One of the qualities I like about you is your strong feelings about things, and your willingness to express them.

My goal in presenting various forms of treatment is because I'm interested in what works for others.

At this stage in my life, I'm devastated with how this illness has affected me, the ways in which it's changed me, and my inability to control it.

What works for you? I'm really interested in knowing. If you'd like to write a post on it, I'll link to you!

Roanne said...

Both of your recent posts on my blog so beautifully express the power of our minds--as well as the minds of healers--to influence our bodies. And the way you are writing here about your own feelings and experiences is itself evidence of your own self-healing power. I admire your strength and what you have achieved. You are a true role model for others.

Bipolar Wellness Writer said...

Since I feel the same way about you, I guess we qualify as a mutual admiration society (of two)!


Roanne Weisman said...

And how nice to know that so many others are also searching for ways to become whole.

Danielle Says Hello said...

I am a huge supporter of therapy. However, it is important that there is a productive match between the individual and the therapy. An excellent therapist will be able to discern this in a matter of sessions. For me, it required a mix - with the most dominant being EMDR therapy.

It is also important that individuals understand the basics of how to choose a therapist.

Gianna said...

I've attempted to give various forms of CBT/DBT a chance and find it invariably insulting. I find the practitioners condescending and the books patronizing.

As ariadnek said---judgmental hogwash.

Personally I like the idea of taking responsibility for my psyche, but I do that by accepting myself, not forcing myself to think differently.

You know Susan, the mental health system strips us of our self-esteem because most of the people practicing don't believe we can be whole, functioning individuals who can recover. I say bulls%^& to that. It's taken years and I'm still trying to shake the self stigmatization but it is bull. If we were approached with the good faith that we are not hopeless and that we can recover we would be much better off.

I'm blessed to have everyone in my life believing that about me now, but much damage has been done.

Bipolar Wellness Writer said...

Thanks so much for your comment. I think it's helpful to know what works for different people.


Bipolar Wellness Writer said...

Thank you so much for commenting. Actually, I was going to respond here, but instead I'm going to use your comment as the basis for tomorrow's post. I agree with you and couldn't say it better.


Jane Doe said...

I went through two years of intense cognitive therapy and it was the best thing I ever did for myself. I've been in therapy on and off for twenty years, and that by far was the most helpful.

Bipolar Wellness Writer said...

Dear Jane Doe,
Thanks for your input. I appreciate another point of view!


ariadneK, Ph.D. said...

I am totally flattered by your assessment of me...many people find me to be too blunt, but I learned long ago that repressing my feelings only makes things stressful in the end. ;-)

I plan to post soon about "what works for me" in maintaining functional stability (I have been going strong, mostly, for over 18 months now!), though it involves both meds and self-discipline, both of which I know various people might have problems with. In any case, you rock and I love your blog, keep on truckin'!

Bipolar Wellness Writer said...

Dear ariadnek,
As I've gotten older I've become more blunt as well, and I realize that people don't seem to like this quality. Perhaps honesty is perceived as a liability--who knows?

Anyway, thanks for the compliment in return. Let me know when you write that post. I believe that whatever works--whether it's medication and self-discipline,or Mariposa's spiritual adviser, the end result is the only thing that matters. That's great news that you're doing so well!